Bridging the epidemiology-policy divide: A consequential and evidence-based framework to optimize population health

Epidemiology is the scientific cornerstone of public health. Its traditional role has been to test scientific hypotheses on causal relationships of exposures with health outcomes, the results of which should in turn be synthesized and lead to evidence-based recommendations and the formation of policy. However, the messy truth is that the path from epidemiology to policy is frequently not a perfectly rational, linear one, and the choices of which scientific hypotheses are pursued and the ways in which they are tested, evaluated, and translated into policies do not occur systematically. One avenue for bridging this divide is widespread adoption and implementation of a consequential, evidence-based framework-whereby we can systematically facilitate the translation of epidemiology into policies and interventions to optimize population health. This paper describes the roadmap for a seven-step, outcomes-based consequential approach, that includes priority-setting of problems at both the federal and regional/state levels, and that proposes to strengthen alignment of public and private research funding and journals with these priorities. Over the long term, implementing this framework should help to bridge the divide between epidemiology and policy and optimize the use of increasingly constrained resources to reduce disease burden and promote the nation's health.